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This policy briefing is based on a review of reports of the Kisumu Primary Health Care project that ran from 1983 to 1997. It sets out to answer three questions around the sustainability of primary health care projects after donors withdraw: how and why do communities carry on the activities after the donor has withdrawn; what can programmes do to encourage such persistence; and what lessons from the Kisumu project can be applied elsewhere?

This policy brief focuses on the outcomes of the Kwale Health Systems Strengthening Project (KHSSP), which aims to improve the quality of health care at the dispensary level. The project increased the participation of the local community in the running of the dispensaries and in the development and operation of the health information system that was used. This brief outlines the projects work and lessons that can be learned from it